Organization
MODERN THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMUD ABDIRIZAKABDI WARDERE (OWNER)
(612) 481-3020
Entity
Organization
Contact information
Practice address
295 MCKNIGHT RD S, SAINT PAUL, MN 55119-5305
(612) 481-3020
Mailing address
295 MCKNIGHT RD S, SAINT PAUL, MN 55119-5305
(612) 481-3020
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
06/26/2025
Last updated
06/26/2025
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